<%@ Control Language="VB" AutoEventWireup="false" CodeFile="Rider.ascx.vb" Inherits="WebForms_Rider" %>
<%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="ajaxToolkit" %>

<div id="divMain" runat="server">
    <script type="text/javascript" language="javascript" src="../scripts/numFormat.js"></script>
    <script type="text/javascript" language="javascript" src="../scripts/dateFunc.js"></script>
    
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px;height: 5px;"></td></tr>
    </table>

    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr>
        <td runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;" id="Name_td">
        </td>
        <td></td>
        </tr>
        <tr>
        <td runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial; height: 19px;" id="policy_td">
            </td>
        <td style="height: 19px"></td>
        </tr>
        <tr>
        <td runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;" id="provider_td">
        </td>
        <td align="right" style="font-weight: bold; font-size: 10pt; font-family: Arial; color: #d63007;">
            Add New Premium</td>
        </tr>
    </table>

    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px; background-color: #105BA4; height: 3px;"></td></tr>
    </table>

    <br />

    <table border="0" cellpadding="0" cellspacing="0" width="800" style="background-color: #f2f3f5">
               
    <tr><td style="width: 800px">

        <table border="0" cellpadding="0" cellspacing="0" width="800" style="height: 35px">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px;" align="left">
                    &nbsp;Premium :</td>
                <td style="width: 290px" align="left">
                    <asp:DropDownList ID="Rider_cmb" runat="server" Width="250px" AutoPostBack="True">
                    </asp:DropDownList></td>
                <td id="tdStartDate" runat="server" style="font-size: 10pt; font-family: Verdana; width: 100px;" align="left">
                    &nbsp;Start Date:</td>
                <td align="left" style="width: 100px">
                    <asp:TextBox ID="StartDate_txt" runat="server" Width="72px"></asp:TextBox><br />
                    <asp:Label ID="lblStartDate" runat="server" Font-Names="Verdana" Font-Overline="False"
                        Font-Size="7pt" ForeColor="Gray" Text="dd/mm/yyyy" Width="64px"></asp:Label></td>
                <td id="tdEndDate" runat="server" style="font-size: 10pt; font-family: Verdana; width: 100px;" align="left">
                    &nbsp;End Date:</td>
                <td align="left" style="width: 100px">
                    <asp:TextBox ID="EndDate_txt" runat="server" Width="72px"></asp:TextBox><br />
                    <asp:Label ID="lblEndDate" runat="server" Font-Names="Verdana" Font-Overline="False"
                        Font-Size="7pt" ForeColor="Gray" Text="dd/mm/yyyy" Width="64px"></asp:Label></td>
            </tr>
        </table>
            
    </td></tr>

    <tr><td style="width: 800px">

        <table border="0" cellpadding="0" cellspacing="0" width="800" style="height: 35px">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px;" align="left">
                    &nbsp;Amount:</td>
                <td style="width: 290px" align="left">
                    <asp:TextBox ID="Premiums_txt" runat="server" Width="250px"></asp:TextBox></td>
                <td id="tdBenefits" runat="server" style="font-size: 10pt; font-family: Verdana; width: 100px;" align="left">
                    &nbsp;Benefits:</td>
                <td align="left" style="width: 300px">
                    <asp:TextBox ID="Benefits_txt" runat="server" Width="250px"></asp:TextBox></td>
            </tr>
        </table>
            
    </td></tr>
    
    <tr><td style="width: 800px; height: 59px;">

        <table border="0" cellpadding="0" cellspacing="0" width="800" style="height: 35px">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 105px;" align="left">
                    &nbsp;Remarks:</td>
                <td style="width: 590px" align="left">
                    <asp:TextBox ID="Remarks_txt" runat="server" TextMode="MultiLine" Width="664px"></asp:TextBox></td>
            </tr>
        </table>
            
    </td></tr>

    <tr><td style="width: 800px; height: 54px;">

        <table border="0" cellpadding="0" cellspacing="0" width="800" style="height: 35px">
            <tr>
                <td style="width: 400px; height: 24px;"></td>
                <td style="height: 24px">
                    <asp:Button ID="Save_btn" runat="server" Text="Save" BackColor="Gainsboro" Font-Names="Verdana" Width="104px" />
                </td>
                <td style="height: 24px">
                    <asp:Button ID="Cancel_btn" runat="server" Text="Back" BackColor="Gainsboro" Font-Names="Verdana" Width="112px" CausesValidation="False" />
                </td>
            </tr>
        </table>
        <ajaxToolkit:MaskedEditExtender ID="MaskedEditExtender1" runat="server" Mask="99/99/9999"
            MaskType="Date" TargetControlID="StartDate_txt">
        </ajaxToolkit:MaskedEditExtender>
        <ajaxToolkit:MaskedEditExtender ID="MaskedEditExtender2" runat="server" Mask="99/99/9999"
            MaskType="Date" TargetControlID="EndDate_txt">
        </ajaxToolkit:MaskedEditExtender>
        <ajaxToolkit:FilteredTextBoxExtender ID="FilteredTextBoxExtender1" runat="server"
            FilterType="Custom, Numbers" TargetControlID="Benefits_txt" ValidChars=".">
        </ajaxToolkit:FilteredTextBoxExtender>
        <ajaxToolkit:FilteredTextBoxExtender ID="FilteredTextBoxExtender2" runat="server"
            FilterType="Custom, Numbers" TargetControlID="Premiums_txt" ValidChars=".">
        </ajaxToolkit:FilteredTextBoxExtender>
            
    </td></tr>

    </table>
<div>
        <asp:RequiredFieldValidator ID="rfv1" runat="server" ControlToValidate="Rider_cmb"
            ErrorMessage="Rider Name Required" ForeColor="White" Text="."></asp:RequiredFieldValidator>
    <asp:CustomValidator ID="dtv1" runat="server" ClientValidationFunction="valDate"
        ControlToValidate="StartDate_txt" ErrorMessage="Invalid Start Date"
        ForeColor="White" ValidateEmptyText="True">.</asp:CustomValidator>
    <asp:CustomValidator ID="dtv2" runat="server" ClientValidationFunction="valDate"
        ControlToValidate="EndDate_txt" ErrorMessage="Invalid End Date" ForeColor="White">.</asp:CustomValidator>
    &nbsp; &nbsp;
        &nbsp;&nbsp;
        <asp:ValidationSummary ID="ValidationSummary1" runat="server" ShowMessageBox="True"
            ShowSummary="False" />
        <br />
        <ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender1" runat="server"
            TargetControlID="rfv1">
        </ajaxToolkit:ValidatorCalloutExtender>
        <ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender2" runat="server"
            TargetControlID="dtv1">
        </ajaxToolkit:ValidatorCalloutExtender><ajaxToolkit:ValidatorCalloutExtender ID="ValidatorCalloutExtender3" runat="server"
            TargetControlID="dtv2">
        </ajaxToolkit:ValidatorCalloutExtender>
    &nbsp; &nbsp; &nbsp; &nbsp;
        &nbsp; &nbsp;&nbsp;
    </div>
</div>